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Oral bisphosphonate renal impairment — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentOral bisphosphonate renal impairmentGPhC CRA

A 78-year-old woman with osteoporosis has eGFR 24 mL/min/1.73m2 and a new prescription for alendronic acid 70mg once weekly. She also has dysphagia. What is the most appropriate action?

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Correct answer: B — Contact the prescriber before supply because renal function and swallowing safety need review

Alendronic acid has renal function cautions and is unsuitable in some patients with significant renal impairment. Dysphagia also increases the risk of oesophageal adverse effects with oral bisphosphonates. The prescriber should review suitability and consider alternatives. Crushing the tablet or taking with milk is inappropriate.

Reference: BNF; NICE CKS